What is nortriptyline?

Nortriptyline may also be used for purposes not listed in this medication guide.

Important information

You should not use nortriptyline if you have recently had a heart attack, or if you are allergic to certain medicines.

Do not use this medicine if you have used a MAO inhibitor in the past 14 days, such as isocarboxazid, linezolid, methylene blue injection, phenelzine, rasagiline, selegiline, or tranylcypromine.

Some young people have thoughts about suicide when first taking an antidepressant. Your doctor will need to check your progress at regular visits while you are using nortriptyline. Your family or other caregivers should also be alert to changes in your mood or symptoms.

Report any new or worsening symptoms to your doctor, such as: mood or behavior changes, anxiety, panic attacks, trouble sleeping, or if you feel impulsive, irritable, agitated, hostile, aggressive, restless, hyperactive (mentally or physically), more depressed, or have thoughts about suicide or hurting yourself.

Before taking this medicine

You should not use nortriptyline if you are allergic to it, or if:

you have recently had a heart attack;

you are allergic to similar antidepressants (amitriptyline, amoxapine, clomipramine, desipramine, doxepin, imipramine, protriptyline, trimipramine); or

Do not use nortriptyline if you have used an MAO inhibitor in the past 14 days. A dangerous drug interaction could occur. MAO inhibitors include isocarboxazid, linezolid, methylene blue injection, phenelzine, rasagiline, selegiline, tranylcypromine, and others.

To make sure nortriptyline is safe for you, tell your doctor if you have:

heart disease, or a history of heart attack, stroke, or seizures;

bipolar disorder (manic-depression);

schizophrenia or other mental illness;

liver disease;

a thyroid disorder;

diabetes (nortriptyline may raise or lower blood sugar);

narrow-angle glaucoma; or

problems with urination.

Some young people have thoughts about suicide when first taking an antidepressant. Your doctor will need to check your progress at regular visits while you are using nortriptyline. Your family or other caregivers should also be alert to changes in your mood or symptoms.

It is not known whether nortriptyline will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant while using this medication.

It is not known whether nortriptyline passes into breast milk or if it could harm a nursing baby. Tell your doctor if you are breast-feeding a baby.

Do not give this medicine to a child without medical advice. Nortriptyline is not approved for use in children.

How should I take nortriptyline?

Take nortriptyline exactly as it was prescribed for you. Follow all directions on your prescription label. Your doctor may occasionally change your dose to make sure you get the best results. Do not take this medicine in larger or smaller amounts or for longer than recommended.

If you need surgery, tell the surgeon ahead of time that you are using nortriptyline. You may need to stop using the medicine for a short time.

Do not stop using nortriptyline suddenly, or you could have unpleasant withdrawal symptoms. Ask your doctor how to safely stop using this medicine.

It may take a few weeks before your symptoms improve. Keep using the medication as directed and tell your doctor if your symptoms do not improve.

Store at room temperature away from moisture and heat.

Nortriptyline dosing information

Usual Adult Dose for Depression:

25 mg orally three or four times per day
Maximum dose: 150 mg orally per day

Comments:
-When doses above 100 mg per day are given, plasma levels should be monitored and maintained in the optimum range of 50 to 150 ng/mL.
-The dosage should be reduced, if a patient develops minor side effects.
-The drug should be discontinued if adverse effects of a serious nature or allergic manifestations develop.
-The total daily dosage may be given once a day.

See also:

What happens if I miss a dose?

Take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. An overdose of nortriptyline can be fatal.

What should I avoid while taking nortriptyline?

Do not drink alcohol. Nortriptyline can increase the effects of alcohol, which could be dangerous.

This medication may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be alert.

Avoid exposure to sunlight or tanning beds. Nortriptyline can make you sunburn more easily. Wear protective clothing and use sunscreen (SPF 30 or higher) when you are outdoors.

Nortriptyline side effects

Get emergency medical help if you have signs of an allergic reaction to nortriptyline: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

Report any new or worsening symptoms to your doctor, such as: mood or behavior changes, anxiety, panic attacks, trouble sleeping, or if you feel impulsive, irritable, agitated, hostile, aggressive, restless, hyperactive (mentally or physically), more depressed, or have thoughts about suicide or hurting yourself.

See also:

What other drugs will affect nortriptyline?

Taking this medicine with other drugs that make you sleepy can worsen this effect. Ask your doctor before taking nortriptyline with a sleeping pill, narcotic pain medicine, muscle relaxer, or medicine for anxiety, depression, or seizures.

Before taking nortriptyline, tell your doctor if you have used an "SSRI" antidepressant in the past 5 weeks, such as citalopram, escitalopram, fluoxetine, fluvoxamine, paroxetine, or sertraline. You must wait at least 5 weeks after stopping fluoxetine (Prozac) before you can take this medicine.

Many drugs can interact with nortriptyline, which may cause unwanted or dangerous effects. This includes prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed in this medication guide. Tell your doctor about all medicines you use, and those you start or stop using during your treatment with nortriptyline. Give a list of all your medicines to any healthcare provider who treats you.